Final Assignments and Quiz Questions Flashcards
The most common site of shoulder impingement is
Between the inferior acromion on the superior humeral head
Which of the following can contribute to shoulder impingement?
All of the above
-Type III acromion
-Thicken subacromial bursa
-Calcific coracoacromial ligament
A 18-year-old athlete was diagnosed with rotator cuff tear and referred to PT outpatient clinic. Which of the following muscles might be torn?
Infraspinatus
As the question described above, PT started initial evaluation on this 18-year-old patient. The PT identified that the patient had severe loss of shoulder ROM and strength, significant swelling and ecchymosis on the shoulder. What grade of the lesion the patient might have?
Grade 3
Which of the following is true on biceps tendonitis?
All of the above
-Biceps tendon injury can involve tendinosis from repetitive overhead use or repetitive activities which cause the humeral head to translate anteriorly and superiorly, therefore impinging the biceps tendon.
-Patient’s symptoms may radiate into elbow.
-Surgery is generally not indicated in cases of biceps tendonitis.
Begin with strengthening of scapular stabilizers is important during the rehabilitation on a patient with shoulder rotator cuff tear. The following muscles are scapular stabilizers EXCEPT?
Supraspinatus
Which of the following movements may aggravate the symptoms in a person with rotator cuff repair?
Hand behind the back
Which of the following is considered as part of shoulder joint complex?
All of the above
-Scapulothoracic joint
-Sternoclavicular joint
-Acromioclavicular joint
Begin with development of scapular stabilizers is important during the rehabilitation on a patient with shoulder impingement syndrome. The following muscles are scapular stabilizers EXCEPT?
Infraspinatus
Which of the following may contribute to shoulder impingement syndrome?
Excessive tightness on pectoralis major due to forward shoulder posture.
If a patient has shoulder pain during shoulder horizontal adduction, which type of shoulder impingement can most likely be the cause?
Coracoid impingement
Which of the following is true about rotator cuff tears?
Chronic subacromial impingement may lead to the injury.
Which of the following might be the symptom found on a patient with rotator cuff tears?
All of the above.
-Peripheral numbness or tingling.
-Thoracic pain.
-Point tender pain at the insertion of teres minor.
A 70-year-old patient with rotator cuff tears and other systemic chronic diseases is consulting with a PT about whether he should receive an open rotator cuff repair. What might be the advantage if the patient decides not to receive surgical treatment?
Avoid the risks of infection from the procedure and complications from anesthesia.
Which of the following movement may aggravate the symptom on a person with rotator cuff tears?
Computer or desk work
_________ involves an accumulation of microtrauma that can lead to degenerative changes in the tendon. These changes include fibrosis, adhesions, and microtears that cause pain and lead to more tendon damage as the disease progresses.
Tendinosis
Which of the following is true on the rehabilitation for biceps tendonitis?
Look for other causes or predisposing factors to the injury can help to prevent future injury.
Which of the following active movements should be limited when treating a patient with one-week post operation for SLAP lesion repair?
Shoulder flexion and elbow flexion
Which of the following can be a sign or symptom of a patient with Bankart lesions ?
All of the above
-Diffuse thoracic or upper trapezius pain
-Clicking or popping with motion
-Feeling of instability
Which of the following is a static stabilizer for glenohumeral joint?
Glenoid labrum
What population is more likely to have shoulder instability?
20-year-old baseball player
Which of the following diseases is associated with higher risk of having adhesive capsulitis?
Hypertriglyceridemia
What is true for adhesive capsulitis?
Codman’s (pendulum) exercises may decrease patient’s symptoms
Cubital tunnel syndrome is a form of mononeuropathy caused by entrapment, compression, stretch, ischemia, infection, or inflammation of the ______ nerve in the cubital tunnel or surrounding tissues.
Ulnar
A 42-year-old was diagnosed with lateral epicondylitis. Which of the following activities may aggravate the patient’s elbow symptoms?
All of the above
-Perform strong gripping.
-Passive stretching of the wrist and finger extensors.
-Apply compression on lateral epicondyle.
Which of the following is true for elbow epicondylitis and its rehabilitation?
Poor technique and a deconditioned musculoskeletal system can be the contributing factors.
What is true about elbow dislocation?
Lateral instability often occurs after elbow dislocation.
What is true for lateral epicondylitis?
It is also called tennis elbow.
What is true for Golfer’s elbow?
Patient’s pain complaints may be sharp or achy and radiate down medial forearm.
The most common type of elbow dislocation is ________ displacement of the olecranon in relation to the humerus.
Posterior
A 55-year-old male carpenter has been referred to PT with a diagnosis of right lateral elbow pain. The PT is making a clinical hypothesis that the patient might have lateral epicondylitis. Which of the following muscles should be checked first to support this hypothesis?
Extensor Carpi Radialis Brevis
As the question described above, what clinical sign and symptom can be seen during the PT evaluation on this patient?
All of the above
-Decreased grip strength
-Pain with passive stretching of the wrist extensor
-Tenderness over lateral epicondyle
Which of the following PT interventions might be the most appropriate during phase four rehabilitation for a patient with medical epicondylitis?
Interval throwing program
What is true for medical epicondylitis?
Patient’s pain complaints may be sharp or achy and radiate down medial forearm.
Which of the following is true for cubital tunnel syndrome?
Improper sleeping patterns such as the arms are fully flexed may contribute to cubital tunnel syndrome.
Which of the following is the common sign or symptom of cubital tunnel syndrome?
Intrinsic muscle wasting.
What is true about elbow dislocation?
Individuals who participate in gymnastics that may predispose him or her to a falling incident are at risk of elbow dislocation.
A 15-year-old male presents to the emergency department after falling on his outstretched hand during a basketball game. X-rays reveal a posterior elbow dislocation. Which of the following factors most likely contributed to his injury?
Participate in sporting activities
Following the elbow dislocation, this 15-year-old male underwent a successful reduction in the emergency department. He is now referred to outpatient physical therapy for rehabilitation. Which of the following is the most appropriate initial management strategy?
Short-term immobilization followed by early controlled motion
A patient presents with numbness and tingling in the ring and little fingers, which worsens when the elbow is flexed for prolonged periods. What is the most likely diagnosis?
Cubital tunnel syndrome
Which of the following interventions would be most appropriate for a patient with mild cubital tunnel syndrome?
Lifestyle modification
A patient presents with a nerve injury that has resulted in Wallerian degeneration. According to the Seddon classification, which of the following stages of nerve injury is most likely present?
Axonotmesis (Stage II)
A patient with lateral epicondylosis is in the third phase of rehabilitation (4-6 weeks). Which of the following exercises would be most appropriate to include in their treatment plan?
Eccentric strengthening of the wrist extensors
A 50-year-old pickleball player reports lateral elbow pain. He notices that his pain is aggravated by gripping the paddle and twisting his forearm during serves, but feels relief when resting and applying ice. Which of the following activities is MOST likely contributing to his symptoms?
Repetitive wrist turning and hand gripping during pickleball play
A 17-year-old male baseball pitcher reports pain on the medial side of his right elbow (dominant arm). He notes the pain started gradually a few weeks ago and has been worsening. He denies any specific trauma. His coach recently adjusted his pitching style to improve speed and accuracy, and he’s been practicing those adjustments more days per week than before. Based on this information and considering contributing factors, which of the following is the MOST likely primary contributing factor to his medial elbow pain?
Beginning a new activity or abruptly increasing the frequency or intensity of the offending activity
Following the initial presentation, the 17-year-old baseball pitcher is diagnosed with medial epicondylitis. During the physical therapy examination, which of the following findings would be MOST consistent with this diagnosis?
Pain with resisted wrist flexion and pronation
As of today, which of the following is a common clinical application of platelet-rich plasma (PRP) therapy?
Rotator cuff tendinopathy
If a patient with De Quervain’s Syndrome chooses conservative treatment (without surgery), the most important single aspect of treatment is:
protecting the tendons from stress through activity modification and splinting.
Which of the following tissues may be involved in De Quervain’s tenosynovitis?
Extensor pollicis brevis and abductor pollicis longus
Which of the following factors may increase the volume of the contents in the carpal tunnel?
Systemic conditions that increase fluid retention such as hypothyroidism and pregnancy.
On patients with carpal tunnel syndrome, the increased pressure leads to ischemia or axonal compression of the ______ nerve, experienced by the patient as pain, paresthesias, and/or numbness in the volar aspect of the radial three digits.
median
People with trigger finger usually develop symptoms of pain and tenderness along the _______ surface of the palm and digit.
volar
A 30-year-old computer engineer has a complaint of pain in the radial aspect of the wrist that refers into the thumb and up the radial side of the forearm. Which of the following pathologies might be related to this symptom?
De Quervain’s syndrome.
Which of the following factors may decrease the volume of the carpal tunnel?
Chronic positioning in mid- to end-ranges of wrist flexion or extension.
Which of the following is a common sign or symptom for carpal tunnel syndrome?
Inability to oppose thumb or atrophy of thenar eminence.
Which of the following tissues may be involved in De Quervain’s tenosynovitis?
Extensor pollicis brevis and abductor pollicis longus
What is true about De Quervain’s syndrome?
Activities involving a wide grip and resistance to ulnar deviation may aggravate the symptoms.
Which of the following is true for trigger finger?
All of the above.
-The hallmark sign of the disorder is catching or “triggering” of the flexor tendons during active or passive flexion/extension of the digits.
-Found more often in manual laborers, farmers, musicians, and others whose occupations involve prolonged and/or forceful gripping.
-Repetitive use, inflammation, and fluid stasis within the fibroosseous tunnel surrounding the digital flexor tendons have all been implicated in trigger finger.
A 82-year-old male was diagnosed with trigger finger on his right hand. During the PT initial evaluation, which of the following might be the patient’s sign and symptom?
The third and fourth digits may be locking at any point in flexion/extension range and with passive or active movement.
What is the rationale for platelet-rich plasma (PRP) therapy?
All of the above
-PRP concentrates can modulate pain and inflammation.
-PRP concentrates can initiate tissue repair via the release of biologically active factors and adhesion proteins by the platelets at the injury site.
-PRP concentrates can stimulate the supraphysiological release of growth factors to jump-start healing in chronic injuries and accelerate the acute injury repair process.
As of today, which of the following is a common clinical application of platelet-rich plasma (PRP) therapy?
Patellar tendinopathy
In general, what is the treatment goal of platelet-rich plasma (PRP) therapy in orthopedic and sport medicine?
To foster soft tissue repair.
What is the function of platelet?
All of the above
-Contribute to angiogenesis.
-Participate in the process of inflammation.
-Release growth factors and cytokines.
Which of the following is true for trigger finger?
The digits may be locked at any point in flexion/extension range and with passive or active movement.
A 22-year-old graphic designer presents with numbness and tingling in her dominant hand, especially in the thumb, index, and middle fingers. She reports that symptoms worsen after prolonged use of a stylus and keyboard during her 8-hour workday. She often wakes up at night with her hand feeling “asleep” and finds relief by shaking it out. Examination reveals decreased grip strength on the affected side. AROM and PROM are WNL.
What is the MOST LIKELY medical diagnosis?
Carpal tunnel syndrome
A new mother presents with radial-sided wrist pain that developed 3 weeks after returning to work while frequently lifting her 6-month-old infant. Pain increases during thumb-assisted grasping and bottle feeding. The physical exam shows grip strength is 4/5 on the affected side. Wrist ROM is normal.
What is the BEST PT clinical impression?
First dorsal compartment tenosynovitis
A 62-year-old gardener reports painful “catching” of her middle finger when gripping tools. Symptoms improve with morning warm compresses but worsen after pruning rose bushes. Physical exam reveals a palpable nodule at the A1 pulley and + triggering during active flexion/extension.
What can be the PRIMARY pathology?
Trigger finger
A 48-year-old patient is referred to your outpatient clinic following a Platelet-Rich Plasma (PRP) injection for chronic wrist extensor tendinopathy. She is now 2 weeks post-injection and reports decreased pain but persistent weakness. Which of the following statements is TRUE regarding the use of PRP in musculoskeletal conditions?
Overall, PRP is a safe therapy alone or in combination with other concurrent treatments.
A 58-year-old seamstress presents with more than 8 months of persistent left middle finger “locking” during gripping motions. Conservative treatment with splinting and corticosteroid injections provided only temporary relief. Physical exam reveals a palpable nodule at the A1 pulley and reproducible triggering. Her orthopedic surgeon recommends surgical intervention.
Which surgical procedure is MOST appropriate for this patient?
Percutaneous A1 pulley release
